Cancer in My Community: Caring for the Whole Patient in Brazil

December 7, 2023
Maria Cecilia Mathias, MD

Cancer in My Community is a Cancer.Net Blog series that shows the global impact of cancer and how people work to care for those with cancer in their region. Maria Cecilia Mathias, MD, is a medical oncologist based in São Paulo, Brazil. Dr. Mathias is an oncology fellow preceptor at the Instituto do Câncer do Estado de São Paulo at the University of São Paulo and a gastrointestinal oncologist with Grupo Oncoclinicas. You can follow Dr. Mathias on X, formerly known as Twitter.

Why I care for people with cancer

I have been learning about cancer care since I was a child. As the daughter of a medical oncologist doing her fellowship in the United States, I would listen to stories about cancer care growing up. I have always found cancer both challenging and fascinating.

Upon becoming a physician and deciding to become a medical oncologist, I began to view cancer care as an opportunity to care for my patients beyond systemic treatments and medical consultations. I began to see that being an oncologist means taking care of so many other aspects beyond treating the cancer itself. Being an oncologist also means addressing the emotional challenges a person faces after a cancer diagnosis, taking care of the patient’s family and the life changes that come with the diagnosis, helping patients manage the happiness of a response but also when there is grief of a progression, or guiding them through end-of-life care.

For me, caring for people with cancer is more than just being a doctor. It comes down to partnering with my patients and their families to help guide them through their cancer treatment.

What cancer is like in Brazil

Brazil relies on both a public and private health system. The public health system, called Sistema Único de Saúde (SUS), aims to guarantee health care access to everyone in the Brazilian territory. SUS has the capacity to offer both basic and complex treatments in cancer care, such as surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy. However, access to some of the newer and more costly treatments can be limited and, due to a high demand and an even higher number of patients, there can be a delay in patients receiving these treatments. Therefore, it is not uncommon to see patients who rely exclusively on the public health system be diagnosed with more advanced cases and face limited access to treatment, especially in more remote parts of the country.

The Brazilian private health system is supported by medical insurance companies that are paid for by a relatively small part of the population. The private health system grants access to more treatment options that are available sooner for people receiving private care.

Another important aspect regarding access to cancer care in Brazil is the delays patients can face after new treatments are approved by the National Health Surveillance Agency (Agência Nacional de Vigilância Sanitária, or ANVISA). After a new treatment is approved, it can take long periods of time for patients to actually receive those treatments. Once the approval is granted and treatments are registered in the list of approved medications, people receiving care in the private health system can use their insurance to receive these new treatments. However, people who rely solely on the public health system for their care often experience even more delayed access.

It is important for people in Brazil to be aware of public incentives for cancer screening, know their treatment options if they receive a cancer diagnosis, and ask about how to get access to these resources. Brazil has a large and unequal population, so access to cancer care is often difficult. However, it is not impossible.

Where people with cancer can find local resources and support in Brazil

People with cancer can access information regarding cancer statistics and treatment options on government websites, such as Instituto Nacional do Câncer (INCA) and the National Health Ministry. They can also learn more about advocacy initiatives, cancer treatment guidelines, and patient rights guaranteed by law on the websites of the Brazilian Society of Clinical Oncology (Sociedade Brasileira de Oncologia Clínica) and OncoGuia.

The author has no relevant relationships to disclose. 

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